Advanced Care Basic, LLC
Organization Active NPI Psychiatric/Mental Health Nurse Practitioner · Middletown, DE
NPI 1174021992 · NPPES record last updated Dec 4, 2022
Key facts
- NPI
- 1174021992
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- Legal business name
- ADVANCED CARE BASIC, LLC
- Practice address
- 3 Emerson CT
Middletown, DE 19709-1646 - Phone
- (215) 586-1393
- Fax
- (302) 378-3697
- NPI assigned
- Jan 26, 2018
- Organization subpart
- No
Authorized official
- Name
- Hallie K Dennison, CRNP
- Title
- Nurse Practitioner
- Phone
- (215) 586-1393
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in DE
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20211123000475 | DE | Part B Supplier - Clinic/Group Practice | 6204225766 |
Receives reassigned benefits from 1 practitioner Practice locations: Middletown, DE |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | |||
| Family Nurse Practitioner |
363LF0000X | |||
| Psychiatric/Mental Health Nurse Practitioner |
363LP0808X | Yes |
Addresses
Primary practice location
3 Emerson CT
Middletown, DE 19709-1646
Mailing address
3 Emerson CT
Middletown, DE 19709-1646
Phone (215) 586-1393
Other providers in Middletown, DE
- Bernard Akihito Addogoh
- Tolulope Aderibigbe
- Admire Medical, LLC
- Vincent Yao Adofoli
- Adult and Adolescent Medicine of Middletown,LLC
- Advanced Family Care LLC
- Advanced Injury Clinic, Inc
- Patrick Adzadu
- Affinity Wellness & Consultants
- Jerise Atock Agha
All providers in Middletown, DE · Psychiatric/Mental Health Nurse Practitioner in Delaware
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 4, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.